Chapter 18
Which statement accurately reflects the prognosis for a client with a personality disorder?
Prognosis varies based on the degree of functional impairment and the client's motivation to change.
Which personality disorder is most commonly found in clinical settings?
borderline personality
The nurse is assessing a client who is diagnosed with borderline personality disorder. Which client statement indicates the client is at risk for self-injurious behavior?
"I have felt so down lately. I don't enjoy doing anything anymore."
A client with a personality disorder is upset and calls the nurse a "stupid cow." Which is an effective initial response to this client's behavior?
Discuss displacement of anger and set limits.
When providing care to a client who consistently attempts to manipulate the staff, the nurse can best maintain the therapeutic milieu by doing what?
Instructing the staff to enforce all unit rules consistently
The nurse is conducting an education group for women at risk for self-mutilation. What is the most important goal for this group?
Learning strategies to refrain from self-harm
A client on an inpatient psychiatric unit has features of borderline personality disorder. The client is frequently angry, has an unstable sense of self, and is highly impulsive. The client can be verbally abusive to staff, who feel manipulated by the client's behaviors. Which intervention does the nurse determine as priority?
setting limits
Which occurs when a client tends to adore and idealize other people even after a brief acquaintance but then quickly leaves them if these others do not meet the client's expectations in some way?
splitting
A nurse is reviewing the medical record of a female client diagnosed with borderline personality disorder (BPD). Which would the nurse identify as one of the strongest risk factors for this disorder?
Abuse as a child
Which cluster of disorders corresponds to symptoms of being dramatic and emotional?
Cluster B
A client is diagnosed with avoidant personality disorder. When assessing the client, which would be evident? Select all that apply.
Timidity Sensitivity to negative comments Fear of rejection
Clients with borderline personality disorder (BPD) are usually admitted to the inpatient setting because they exhibit what?
self-harm
The most serious consequence of behaviors seen in borderline personality disorder includes what?
self-injury
A client with borderline personality disorder has been admitted to the inpatient unit because the client has been engaging in wrist cutting. The client's sibling is visiting, and the sibling asks the nurse to explain why the client sometimes does this. Which response by the nurse would be most appropriate?
"Sometimes the self-injurious behavior is undertaken to relieve stress."
The nurse is caring for a client with antisocial personality disorder. Which statement is most appropriate for the nurse to make when explaining unit rules and expectations to the client?
"You'll be expected to attend group therapy each day."
While shopping in a grocery store, a client with borderline personality disorder (BPD) greets the sibling of a neighbor with a great big hug. Then about 5 minutes later, the client walks past the sibling and ignores the sibling. The client is demonstrating what?
Affective instability
A personality disorder is defined as a collection of traits that do what?
Cause behavioral dysfunction and inner distress
The nurse in charge of an inpatient psychiatric unit is irritated with a client who has borderline personality disorder. Which step should the nurse take?
Discuss the feelings with a colleague to promote coping.
A client diagnosed with schizoid personality disorder is described by family members as what?
Eccentric and a loner
A nurse is preparing a teaching plan for a client with antisocial disorder. Which would the nurse most likely employ to promote successful education?
Engaging the client in a discussion to direct the topic to the client.
The nurse in charge of an inpatient psychiatric unit is frustrated and angry with a client who has borderline personality disorder. Which steps should the nurse take?
Examine the nurse's own feelings to discover the source of the nurse's anger.
Which would be the priority nursing diagnosis for a client diagnosed with borderline personality disorder (BPD)?
Risk for self-mutilation
A nurse is assessing a client diagnosed with avoidant personality disorder. Which would the nurse expect to find? Select all that apply.
Shyness Feelings of inadequacy
When developing the plan of care for a client with borderline personality disorder (BPD), which areas would the nurse identify as likely problematic? Select all that apply.
Sleep Nutrition Self-harm
The nurse is counseling a 28-year-old client with avoidant personality disorder. Despite being employed, the client verbalizes having low quality of life due to anxiety and isolation. Which therapeutic goals does the nurse establish as priority?
The client will experience increased self-esteem.
A group of nursing students is reviewing information about antisocial personality disorder. The students demonstrate understanding of this disorder when they state what?
The individual must be at least 18 years of age.
After teaching a group of nurses about borderline personality disorder, the leader determines that the education was successful when the group identifies that symptoms typically begin in which age group
adolescence
A 30-year-old client who has not paid rent in 4 months is being evicted from an apartment. The client is brought to the hospital after the client uses a kitchen knife to cut the client's wrist in response to the stress of the eviction. The client's behavior is consistent with what?
borderline personality disorder
Treatment approaches for clients with personality disorders generally rely on which modality?
combination of approaches
After reviewing information about different personality disorders, a group of nursing students demonstrates understanding when they identify which as associated with schizoid personality disorder?
introverted
